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General NPI Number Information
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NPI Number | 1003819657
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Entity Type | Individual
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Provider Name | ROBERT HARRIS FRIEDMAN D.M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/27/2005
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Last Update Date | 10/17/2023
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Provider Practice Location Address
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Address Line | 450031 STATE ROAD 200
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City | CALLAHAN
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State | FL
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Zip | 32011-3847
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Country | US
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Telephone | 904-879-1893
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Fax |
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Provider Business Mailing Address
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Address Line | 86175 MEADOWFIELD BLUFFS RD
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City | YULEE
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State | FL
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Zip | 32097-8412
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Country | US
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Telephone | 904-556-4692
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Fax | 904-261-8181
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 10749
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | DN10749
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License Number State | FL
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